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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501816_"><span class="title" itemprop="name">Sage</span></h1><p class="small">Last Revision: <span itemprop="dateModified">November 15, 2024</span>.</p><p><em>Estimated reading time: 4 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 8022-56-8</p><div id="LM903.Drug_Levels_and_Effects"><h2 id="_LM903_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM903.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Sage (<i>Salvia officinalis</i>) leaf contains tannins (salviatannin), essential oils (including alpha-thujone, beta-thujone, 1,8 cineole, and camphor), flavones, phenolic acids, phenylpropanoid glycosides, triterpenoids, and diterpenes. Spanish sage (<i>Salvia lavandulaefolia</i>) is a related species with similar components, although its thujone content is lower. Sage is often misidentified and adulterated; <i>Salvia bertolonii</i> or <i>Salvia pratensis</i> are sometimes used in instead of <i>Salvia officinalis</i> or as an adulterant. Sage purportedly reduces lactation and has been used to aid with weaning or an overabundant milk supply;[<a class="bk_pop" href="#LM903.REF.1">1</a>-<a class="bk_pop" href="#LM903.REF.4">4</a>] although <i>Salvia nemorosa</i> is reportedly used in Türkiye to increase milk supply.[<a class="bk_pop" href="#LM903.REF.5">5</a>,<a class="bk_pop" href="#LM903.REF.6">6</a>] No scientific studies could be located that evaluate the effect of sage on the milk supply. No data exist on the safety of sage in nursing mothers or infants. In general, sage is well tolerated, with occasional nausea, vomiting, abdominal pain, dizziness, agitation, and wheezing. Thujone and camphor are both neurotoxic in high doses.</p><p>Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to <i>prove</i> the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does <i>not</i> certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information <a href="/books/n/lactmed/LactMedDietarySupps/">about dietary supplements</a> is available elsewhere on the LactMed Web site.</p></div><div id="LM903.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Twelve nursing mothers who were19 weeks to 19 months postpartum ingested 100 mg of 1,8 cineole (eucalyptol) in the form of delayed-release capsules (Soledum-Klosterfrau Vertriebs GmbH, Germany) that release the drug in the intestine. Then they pumped 1 to 4 milk samples at the time they perceived the smell of eucalyptus on their breath which had been previously shown to be approximately concurrent. A total of 21 milk samples were obtained. Odor was rated by a panel of 3 to 5 experts as either smelling like eucalyptus or not. Fourteen of the samples had a distinct eucalyptus-like odor. Chemical analysis of the positive odor tests found 1,8-cineole in concentrations from 70 to about 2090 mcg/kg of milk, most in the range of 100 to 500 mcg/kg of milk. Samples with negative odor tests contained concentrations in the range of 0.98 to about 20.23 mcg/kg of milk. In one woman who donated 3 samples, the highest concentration of 71 mcg/kg occurred at 1.5 hours after ingestion, with concentrations of 1 mcg/kg before ingestion and 15 mcg/kg at 9.5 hours after ingestion.[<a class="bk_pop" href="#LM903.REF.7">7</a>] Eight women had their milk analyzed for 1,8-cineole metabolites. Ten metabolites and several enantiomers of these metabolites were detected.[<a class="bk_pop" href="#LM903.REF.8">8</a>,<a class="bk_pop" href="#LM903.REF.9">9</a>]</p><p>Twenty nursing mothers who were nursing their infants with a mean of 25 weeks of age were served a standardized curry dish that contained an average of 400 mcg of 1,8-cineole. Mothers donated one milk sample each before and 1, 2, 3, 4, 5, 6, and 8 h after the eating the curry dish. 1,8-Cineole reached its maximum concentration in milk after 1 hour in three participants, after 2 hours in four participants, after 3 hours in three participants, after 4 hours in three participants after 5 hours in three participants, after 6 hours in three participants and after 8 hours in one participant. Peak milk 1,8-cineole concentrations ranged from 0.98 to 10.1 mcg/L.[<a class="bk_pop" href="#LM903.REF.10">10</a>]</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM903.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Nursing mothers who were participating in an experiment on the excretion of 1,8-cineole (eucalyptol) in breastmilk took a 100 mg capsule of 1,8-cineole orally. Although instructed not to, 12 mothers breastfed their infants during the experiment. Mothers reported that none of their infants refused their milk or breastfed less than usual. Two mothers felt that their infants were more agitated a few hours after breastfeeding. A third mother reported that the infant stopped nursing from time to time and "looked puzzled", but resumed nursing. Upon repeating the experiment 6 weeks later, the infant did not react in an unusual way during breastfeeding.[<a class="bk_pop" href="#LM903.REF.7">7</a>]</p></div><div id="LM903.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM903.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM903.REF.1">Yarnell
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E.
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Botanical medicine in pregnancy and lactation.
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Altern Complement Ther
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1997;3 (April):93-100. doi:10.1089/act.1997.3.93 [<a href="http://dx.crossref.org/10.1089/act.1997.3.93" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM903.REF.2">Scott
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CR, Jacobson
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H. A selection of international nutritional and herbal remedies for breastfeeding concerns.
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Midwifery Today Int Midwife
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2005;75:38-9.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/16320878" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16320878</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM903.REF.3">Amir
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LH, Pirotta
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MV, Raval
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M. Breastfeeding - Evidence based guidelines for the use of medicines.
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Aust Fam Physician
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2011;40:684-90.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21894275" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21894275</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM903.REF.4">Eglash
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A.
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Treatment of maternal hypergalactia.
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Breastfeed Med
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2014;9:423-5.
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[<a href="/pmc/articles/PMC4216483/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4216483</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25361472" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25361472</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM903.REF.5">Kaygusuz
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M, Gümüştakım
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RŞ, Kuş
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C, et al.
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TCM use in pregnant women and nursing mothers: A study from Turkey.
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Complement Ther Clin Pract
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2020;42:101300.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/33412511" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33412511</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM903.REF.6">Erarslan
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ZB, Kültür
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S. Medicinal plants traditionally used to increase breast milk in Turkey: An ethnobotanical review.
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J Herbal Med
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2024;44:100849. doi:10.1016/j.hermed.2024.100849 [<a href="http://dx.crossref.org/10.1016/j.hermed.2024.100849" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="LM903.REF.7">Kirsch
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F, Beauchamp
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J, Buettner
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A. Time-dependent aroma changes in breast milk after oral intake of a pharmacological preparation containing 1,8-cineole.
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Clin Nutr
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2012;31:682-92.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/22405404" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22405404</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="LM903.REF.8">Kirsch
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F, Buettner
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A. Characterisation of the metabolites of 1,8-cineole transferred into human milk: Concentrations and ratio of enantiomers.
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Metabolites
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2013;3:47-71.
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[<a href="/pmc/articles/PMC3901259/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3901259</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24957890" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24957890</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="LM903.REF.9">Kirsch
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F, Horst
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K, Rohrig
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W, et al.
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Tracing metabolite profiles in human milk: Studies on the odorant 1,8-cineole transferred into breast milk after oral intake.
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Metabolomics
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2013;3:47-71. doi:10.1007/s11306-012-0466-9 [<a href="http://dx.crossref.org/10.1007/s11306-012-0466-9" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>10.</dt><dd><div class="bk_ref" id="LM903.REF.10">Debong
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MW, Homm
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I, Gigl
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M, et al.
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Curry-odorants and their metabolites transfer into human milk and urine.
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Mol Nutr Food Res
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2024;68:e2300831.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/38602198" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 38602198</span></a>]</div></dd></dl></div></div><div id="LM903.Substance_Identification"><h2 id="_LM903_Substance_Identification_">Substance Identification</h2><div id="LM903.Substance_Name"><h3>Substance Name</h3><p>Sage</p></div><div id="LM903.Scientific_Name"><h3>Scientific Name</h3><p>Salvia officinalis</p></div><div id="LM903.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>8022-56-8</p></div><div id="LM903.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Complementary Therapies</p><p>Phytotherapy</p><p>Plants, Medicinal</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div><div class="small"><span class="label">Bookshelf ID: NBK501816</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/30000875" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">30000875</a></span></div><div style="margin-top:2em" class="bk_noprnt"><a class="bk_cntns" href="/books/n/lactmed/">Contents</a><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/lactmed/LM1464/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/lactmed/LM1108/" title="Next page in this title">Next ></a></div></div></div></div>
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